Friday, January 7, 2011

Pump Class

Oh boy! Where do I even begin?

I felt like we were back at square one again because I really didn't know much about MiniMed vs. Animas. All I really knew was what I read and the reviews that you all gave me. I went into the class with a very open mind and I had no clue which pump we'd end up really looking at.

As we got off the elevator, the MiniMed pump rep snagged us and began his "spill" about the pump and all it's perks. I sorta felt like we were shopping for a new car and he was the salesman! There was another family there with us and he went on and on about how the pump works. About half way through, he asked if we had any questions. Ummm....wrong question! LOL! I gave him a run for his money and blasted him with all the questions I had. Kacey had a MiniMed pump in her hand but she didn't have a smile on her face. My first question to the MiniMed rep was....Is it true, since it's what I hear, the MiniMed CGM sites are MUCH more painful than the Dexcom sites? He gave me a bit of a puzzled look and I explained that we were already pumpers and we were choosing our next pump but the CGM was something we really wanted with as little pain as possible. He then went on to tell us how it worked. Thats NOT what I asked! I asked if it was painful? So then he explained how it was inserted. NO! Thats NOT what I asked! He finally said, "What have your Mom bloggers said about it?" (Yep, told him I'd talked to all of you about it!) Again I said, "I heard it was painful and uncomfortable." He then replied, "Well it's a larger needle than your infusion set." Kacey handed the pump back and looked at me with the "Mom Im ready to go" look. We breezed right by the OmniPod rep since she wasn't interested at all. (I will come back to this later on) Around the corner stood...Animas! I've been tossing back and forth over this and it didn't take long to settle myself when I saw the smile come across Kacey's face. It was the smile I saw when she first held a Cozmo pump. We were tickled to see Kacey's very first CDE, Nurse A. She was there the night Kacey was diagnosed, she was there the horrible morning after, she was there when we chose "Herbie" and now here she was again...only this time she was not there as a CDE. She is now a rep for Animas! This settled my nerves as well. She was helping another family so we started talking with the other rep, who happened to have one fantastic personality! I stood there watching Kacey press the buttons as she showed her how to bolus and my heart was swelling. I listened as Kacey asked questions. She told the rep about her favorite features and of course, I voiced mine. Kacey was fascinated with the remote and the color, VERY easy to read and navigate screen on the pump. After we talked to the reps, we went into another room for the class. Since we're pump upgrades, we didn't have to sit through the class with all the other new pumpers. We were in a class with another family that were also Cozmo users and having the same issues that we are. Their daughter has been on a Cozmo for 6 years and they were looking at Animas and Omnipod. After a very informal question and answer session, we were given the chance to try on a pod if we wanted or we could try a new infusion set. The other little girl was interested in the Omnipod so she went first and we all watched as the pod was filled and applied. The girl did not realize that she was going to actually get stuck so it was quite a shock when the CDE said, "Here it comes" and we all heard a "shunk" sound. The girls eyes got as big as quarters as she realized she got stuck and she immediately tried to hold back tears as she walked back to her chair in front of Kacey. It was only a few minutes before she began to cry...and then I looked over to see Kacey in full blown tears!!! I hugged her and asked her why in the world she was crying? She continued to cry harder as she said, "Cuz I know her pain". Well then the little girls Mom and I both welled up with tears because we all felt it! I then went on to ask more questions about the Omnipod because I really wasn't that familiar with it but I didn't want to completely rule it out, even though Kacey already had. Over a 3 day period, Kacey takes in about 240-250 units so this would mean we'd be changing the pod every 2 days instead of every 3. thing that I didn't realize was...once the insulin is in the pod, there is no extracting it. So if you bump the pod and it comes loose and you have to take it off, then you lose that insulin! Ummm...for us....we're using just about 3 vials a month and if we're making those sorts of boo-boo's then we're going to run short on insulin and that completely scares the crap out of me! Then, the thought of the PDA being something she has to carry around unattached and the thought of it being left somewhere and no way to give a bolus other than the PDA. We just didn't think the Omnipod was something that was right for us right now. Yep, Kacey already knew that but I wanted to give it a chance! I know the Omnipod has been wonderful for many of you and it's so nice to love your pump :) (please dont send over any hate comments...LOL!) So then, my other questions were directed for CGM's. I wanted to hear about all the differences in the MM vs. Dex....and I got them! I got to see that freakin HUGE needle/cannula from the MiniMed CGM (yowserssss! bless those of you that can wear it comfortably!) but then I got what I asked for...pros and cons of each one. The CDE had to be neutral since it was ultimately our decision as to which one was being chosen and she didn't want to sway us in any way. So that was nice but there are times when you do want some validation that you're making the right choice...even though there really isn't a right or wrong choice with these pumps. It's all about preference and what works for you or your child. So.......what did I do? I went back to Nurse A, of course! I knew she could give me the feedback I was looking for :) and she did! Kacey pressed more buttons and played with the Ping remote while I asked more questions about Dexcom. While we were in the other room, I did learn something that I did NOT know about CGM's. For those of you using the Dexcom, did you know that it's not pediatric approved and it's not accurate when taking acetaphetamine? This was new for me! So the CDE was telling us that our Endo office does not have a Dexcom rep because they are a pediatric Endo office and it is not something approved for pediatrics....BUT it is something we can choose if we want it but she wanted us to understand that if we needed help with it then they could only give us the 1-800 number to refer to since they wouldn't have anyone there to help. WOW! OK...the CDE had told us she had worn both sensors before and she did find the MM sensor to be a bit uncomfortable but then we also had to realize that the Dex sensor is wire thin and we had to ask ourselves what would we do if that thin wire sensor broke off in her skin? Yikes! Talk about not wanting a CGM...haha! So then I talked with Nurse A some more about the whole issue with medication and she asked me, "Would you check Kacey's sugar more when shes sick and has a fever?" Ummmm, yep! "OK, then you don't need that Dex sensor to be accurate, right?" Ahhhh, right! I also found out....50% of MM users that used the MM CGM ended up switching to a Dex :) So again, it's all in what you want. I felt like I learned so much and I asked so many more questions than I did the first time we went to class. It felt great!

Sooooo....what did Kacey choose?

Kacey chose the pink Animas ping with a pink & purple camo case and a Dexcom CGM.

I have to fill out all of the paperwork and fax it in on Monday. I'm not sure what our out of pocket expense is going to be yet but we were told that Animas would give us a trade in allowance if we traded her Cozmo. As soon as she heard that, she broke down! "Mommy, PLEASE don't make me give my Cozmo to them!" Ughhhhhhh! We went through enough trauma when we had to send "Herbie" back so I don't think we are going to trade in "Goober". I will just let her keep it as a spare since she will still be able to use the Comfort Short sites with the Animas pump (another reason we liked it!) Kacey is dead set against using any of the automatic inserter things. We use the manual insert ones and thats what she is comfortable with....and thats fine...but I'm glad we will have the option of the automatic ones because I'm guessing within the next year she will want to do a site on her own. But for now, we're sticking with what works for us! :)

So to all of you that gave me all the wonderful info on both pumps....THANK YOU! I went into the class with the knowledge that you all had given me and I was able to say, "Well my D-Mom friends said....." and that was some nice back up! :)

Tomorrow is another BIG day for us! We go to meet the diabetic alert dogs and see how they work. We're very excited! I promise to get some pics :) I took my camera to pump class with the intentions of getting pics and I ended up so involved with questions and pushing buttons that I forgot to get a few pics. So I will be sure to capture some pics and hopefully some video :) It's going to be a neat experience and I'm thrilled to get the ball rolling on this!


Nicole said...

I can't wait to see a pic of Kacey and her new pump :)

Laura @ Houston We Have A Problem! said...

No hate here. We love the OmniPod but it not for everyone. Although we do extract insulin out of the pods if they fall off. FDA says NO but mama Houston pancreas says YES! :)

I am so thrilled she is getting the pink ping! AWESOME! I hope she loves it as much as Herbie. :)

BTW - I mailed Kacey & the fam 2 OrnaPods for your tree next year.

Please tell Kacey that the pods don't really hurt when they are put on --- the noise is much worse than the pain. I have a love/hate relationship with that 'shunk' noise. It helps me because I know it's in but it scares the crap out of Nate unless I count it down for him.

Congrats, Kacey!! XOXOX, The Houston Family

Laura @ Houston We Have A Problem! said...

and that was supposed to say it IS not

Jill said...

Nicole...I will definately share pics!!! :)

THANK YOU LAURA!!!! I just told Kacey about the ornaments and she is jumping up and down :) We atually shared your idea last night at class. The rep we know was talking about how some kids decorate them with stickers and markers so they look "cool" while they're wearing them and I told them about what you did once they came off. They had never heard of it and thought it was an amazing idea!!! <3 We're honored to have 2 of them for our tree and we'll definately think of Lil Nate when we hang them each year!

I told the CDE that we look at insulin as if it was liquid gold and since we have to fight the insurance companies just to get the vials that we do, then I couldn't imagine "wasting" it if the pod fell off or it dropped on the floor before we applied it. She made it sound like it couldn't be extracted at it's a little more comforting to know that it CAN be extracted! This Momma Pancreas would be extracting it too! ;)

She already has a name picked out for the pink one. I'm not going to reveal it yet but she seems VERY excited! I don't think she "bonded" with "Goober" like she did with "Herbie" so it makes the switch just a little easier. Blessings!

That "shunk" noise is pretty scary! It reminded me of the lancet thingys they used when Kacey was in PICU. The ones that left those nasty bruises and hurt like hell! I think thats why shes scared of the automatic inserters too. She knows I am controlling the needle force with the manual ones but with those automatic things, you dont know how hard it's going to hit your skin or if it's going to go all the way in. We still do the counting too...I count 1...2...(then Kacey sucks a deep breath and holds it)...3 (I stick) and then she lets the breath out and I draw out the needle and finish sticking the site down.

Thanks so much!!!! (((HUGS)))

Wendy said...

So awesome that you have access to so much information! When we were making our pump decision, I had to find all the information myself -- call the reps, ask questionw...there just wasn't anything like a "pump class". AWESOME!

I did know that about Dex -- as far as I'm aware, there isn't a CGM approved for children under the age of 7. Dex chooses to disclose this up front, because insurance companies can use it as a loophole. The FDA is cracking down on diabetes devices and it's making things a tad difficult.

As for the affects the glucose level of interstitial fluid. Since both Dex and MM measure the glucose in interstitial fluid, I would expect it to also affect a MM CGM reading, though I don't know that for sure. I just don't see how it wouldn't.

RE: Omnipod -- Oh, sweet compassionate, loving Kacey!!! Tell her that they really don't hurt. The sound can be unsettling, but I've worn one a few times and never felt a twinge of "OUCH". Your reservations are similar to mine.

I think you'll LOVE the PING!!! So excited for this new adventure :)

Tracy (The Crazy Pancreas) said...

Yay for a new pump/CGMS decision!

I think you/Kacey will be happy with the choices you made.

I saw the needle for the MM CGM as well and thought to myself that I could never put that into my then 3 year old. So happy with Dexie.

And yep, not approved for kids. And yep, no Tylenol. I remembered that one the hard way. I hated being without it while we waited for the Tylenol to wear off. Even when they are sick and you might be checking more, it is nice to have the trends on Dex. We use Motrin unless we have no other choice.

Can't wait to read how your transition goes!

asskeeper said...

I am one who switched from Cozmo to the animas/Dexcom combo. I have to tell you there is a period of adjustment there, but I am very happy with my decision. I personally love my dexcom and say they will have to pry the pump out of one cold dead hand and the dexcom out of the other.

Misty said...

Awesome! I hope that Kacey loves her new pump and Dex. You did an awesome job of getting all the info you could to make the best decision for you all!

We use the MM CGM and yes, I get sweaty palms EVERY SINGLE TIME I insert a sensor with that big honkin needle. But Ally doesn't complain about it being uncomfortable.

Can't wait to hear about meeting the dogs!!!

Shannon@ The New Normal Life said...

Jill it was so great to chat with you the other night!! I called the kennel and chatted with Scott too!! He is very nice and we are so lucky to have him here locally!! Please let me know what you think when you go! Sad you will only be 15 mins away from me and Im not avaiable to meet tomorrow.. :( Glad pump class went well we are going to try and go in March after Dads surgery!! THANKS for everything the other night!!

Alexis of Justices Misbehaving Pancreas said...

What a sweet girl you have! Congrats on Ping. We adore ours!